The prevalence of contraindications to total disc replacement in a cohort of lumbar surgical patients.

Abstract:

STUDY DESIGN:This is a retrospective review of the epidemiology of contraindications to lumbar total disc replacement (TDR). OBJECTIVE:To define the prevalence of contraindications to lumbar total disc replacement in a cohort of patients undergoing lumbar surgery in the senior author's (F.P.C.) practice. SUMMARY OF BACKGROUND DATA:No published reports have documented the prevalence of contraindications to lumbar total disc replacement. METHODS:We performed a retrospective review of 100 consecutive patients who had lumbar surgery by one surgeon between September and December 2002. Procedures performed and contraindications to TDR were recorded. Contraindications to TDR included central or lateral recess stenosis, facet arthrosis, spondylolysis or spondylolisthesis, herniated nucleus pulposus with radiculopathy, scoliosis, osteoporosis, and postsurgical pseudarthrosis or deficiency of posterior elements. Patients were divided into fusion and nonfusion groups. The percentage of patients without contraindications to TDR was calculated. RESULTS:Of 100 patients, 56 had fusions and 44 had nonfusion surgery. In the fusion group, 56 of 56 patients had contraindications to TDR. In the nonfusion group, 11% (5 of 44) were candidates for TDR. Overall, 5% of patients in this series were candidates for TDR. The average number of contraindications to TDR was 2.48 (range, 0-5). CONCLUSIONS:Predictions that TDR will replace fusion are premature. A small percentage (5%) of the patients currently indicated for lumbar surgery at our institution have no contraindications to TDR. Future growth in TDR implantation will result from the indication of patients for surgery who would not be indicated today or from the elimination of current contraindications.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Huang RC,Lim MR,Girardi FP,Cammisa FP Jr

doi

10.1097/01.brs.0000144829.57885.20

keywords:

subject

Has Abstract

pub_date

2004-11-15 00:00:00

pages

2538-41

issue

22

eissn

0362-2436

issn

1528-1159

pii

00007632-200411150-00014

journal_volume

29

pub_type

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